Back Pain And How To Beat It

Stress Control, Exercise Can Prevent Adults' Most Common Ailment

October 28, 1997|By Stephanie Levin-Gervasi, New York Times Special Features

For much of his adult life, San Francisco executive Ron Wright climbed regularly, swam often and ran the Boston, San Francisco and Sacramento marathons. And he never had a pain . . . until summer 1996.

''I bent down to pick up a bag of dirt and froze,'' Wright recalls. ''The lightning-bolt pain in my lower back knocked the breath out of me.''

Wright had strained a muscle, the most frequent cause of lower-back pain. And at that moment he discovered what 80 percent of Americans will learn at some time in their lives: When your back hurts, it really hurts.

Whether it's a chronic, dull ache or a sharp, sudden pain, back trouble is the most common physical complaint among adults in the United States.

But although a complete cure isn't always possible, there's plenty you can do to avoid back pain, or at least control it. Stress management, exercise, better posture and better movement habits can all help keep a backache from getting the better of you.

The ''backbone'' consists of 33 irregular, bricklike vertebrae that surround and protect the spinal cord and are separated by shock-absorbing pads, or discs. Stacked in an elongated S-curve, this slinky masterpiece would collapse if not for the muscles and ligaments that keep it erect. When these structural elements weaken, the spine begins to lose its support.

Although backaches have plagued mankind for centuries, they're flourishing under today's sedentary lifestyles.

''The back wasn't designed for six-hour stints in a chair. Sitting for extended periods puts pressure on the lower-back discs,'' says Dr. James Zucherman, director of St. Mary's Spine Center in San Francisco.

As occasional athletes often find, intermittent activity can make the problem even worse, because it forces the back to deal with extra stress it isn't prepared for.

''A sedentary job matched with heavy weekend workouts can set your back up for injury,'' Zucherman says.

A less tangible cause of back pain is stress, caused by anything from a high-pressure job to arguments with your spouse. Especially in the absence of regular exercise, stress can constrict blood vessels and play a role in causing gnarled muscles and pinched nerves. Stress is a common culprit when unexplained back pain strikes otherwise healthy people, as are obesity and poor posture.

All these problems can contribute to something much more painful than an everyday backache: a herniated disc.

By age 25, the cushioning discs between the vertebrae begin to dehydrate and lose their resiliency. Bending, sitting or lifting improperly can compound the process.

Then the thick, fibrous outer pad that protects the jellylike center can be pushed outward and even tear, allowing the jelly to seep through and make painful contact with the nerve root. Because any movement hurts, this problem will most likely keep you in bed for days. Luckily, unless the rupture causes severe nerve compression, the pain eventually subsides.

Acute back pain also can result from an accident or sports injury. This is the body's fire alarm, indicating that you need immediate medical attention. Other signs include numbness, tingling and lack of muscle coordination, any of which suggest potential nerve damage.

Luckily, most episodes of back pain go away within four weeks. But that doesn't mean yours will, or that you shouldn't try to heal more quickly.

At the first sign of back pain, start with this basic home remedy, says Dr. David Schechter, a professor of sports medicine at the University of Southern California in Los Angeles.

''To soothe inflammation and reduce pain, apply ice packs for 20-minute intervals,'' he says. ''Don't use a heating pad during the first 48 hours, as it can further inflame irritated tissue.

''Rest but stay mobile and stretch a tad,'' Schechter continues. ''Take ibuprofen as instructed, cutting back after two weeks, and remember that it can irritate the stomach. Try getting a massage, which can relax muscle spasms and will jump-start the endorphins.''

If you don't feel relief after three days, see a doctor to make sure that the pain isn't a symptom of a serious disease, such as cancer or a spinal infection.

Be extremely careful if a doctor suggests surgery, however. From 20 percent to 40 percent of surgeries do not have the expected outcome. And if surgery fails the first time, your chances of success the second time plummet, so examine all other options first.

If you have chronic back pain, it may be time to give up your favorite sports. The twisting and pivoting of a golf swing leave the spine vulnerable to injury, for example, while racquetball's intense twisting and bending can be fatal to a faltering spine, and the forward-bending motion of rowing puts extra stress on the lower discs.

Jogging on cement jars the joints, so find a softer surface. And any contact sport carries a risk of back injury.

But don't give up on exercise. In most cases, doing so will only make back pain worse.

Instead, discuss your options with a doctor who understands sports medicine. Ask which activities are most beneficial - swimming, walking and riding a well-fitted bike are good ones - and how you can modify your workout program.